Category: Nevin Manimala

J Clin Endocrinol Metab. 2023 Jun 3:dgad333. doi: 10.1210/clinem/dgad333. Online ahead of print.

ABSTRACT

CONTEXT: The lack of syndrome-specific reference ranges for thyroid function tests (TFT) among pediatric patients with Down syndrome (DS) results in an overestimation of the occurrence of hypothyroidism in this population.

OBJECTIVES: a) to outline the age-dependent distribution of TFT among pediatric patients with DS; b) to describe the intraindividual variability of TFT over time; c) to assess the role of elevated TSH in predicting the future onset of overt hypothyroidism.

DESIGN: Retrospective, monocentric, observational analysis.

PATIENTS: We included 548 Down patients (0-18 years) longitudinally assessed between 1992 and 2022. Exclusion criteria: abnormal thyroid anatomy, treatments affecting TFT and positive thyroid auto-antibodies.

RESULTS: We determined the age-dependent distribution of TSH, FT3 and FT4 and outlined the relative nomograms for children with DS. Compared to non-syndromic patients, median TSH levels were statistically greater at any age (p < 0.001). Median FT3 and FT4 levels were statistically lower than controls (p < 0.001) only in specific age classes (0-11 for FT3, 11-18 years for FT4).TSH levels showed a remarkable fluctuation over time, with a poor (23-53%) agreement between the TSH centile classes at two sequential assessments.Finally, the 75th centile was the threshold above which TSH values predicted future evolution into overt hypothyroidism with the best statistical accuracy, with a satisfactory negative predictive value (NPP, 0.91), but poor positive (P) PV (0.15).

CONCLUSIONS: By longitudinally assessing TFT in a wide pediatric DS population, we outlined the syndrome-specific reference nomograms for TSH, FT3 and FT4 and demonstrated a persistent upward shift of TSH compared to non-syndromic children.

PMID:37279507 | DOI:10.1210/clinem/dgad333

J Clin Endocrinol Metab. 2023 Jun 3:dgad316. doi: 10.1210/clinem/dgad316. Online ahead of print.

ABSTRACT

CONTEXT: Primary hyperparathyroidism (PHPT) is the most common cause of hypercalcemia, yet long-term (5- and 10-year) recurrence rates after curative surgery have been unclear.

OBJECTIVE: To perform the first systematic review and meta-analysis investigating the long-term recurrence rates of sporadic PHPT after successful parathyroidectomy.

DATA SOURCES: A comprehensive search of multiple databases (including PubMed, EMBASE, Cochrane, EBSCO-CINHAL, EMBASE, Ovid, Scopus, and Google Scholar) was performed from each database’s inception to January 18, 2023.

STUDY SELECTION: Observational studies reporting at least five years of follow-up data after surgical resection were included. Two reviewers independently screened articles for relevance. Of 5,769 articles initially identified, 242 were examined in full-text review and 34 were deemed eligible for inclusion.

DATA EXTRACTION: Two authors independently performed data extraction and study appraisal, using the NIH study quality assessment tools.

DATA SYNTHESIS: Of 30,658 participants, 350 patients (1.1%) experienced recurrence after resection. A meta-analysis of proportions was performed to obtain the pooled recurrence rates. The pooled estimate for overall recurrence rate was 1.56% (95% CI 0.96-2.28%; I2 = 91%). The pooled estimates for 5- and 10- year recurrence rate after resection were 0.23% (0.04-0.53%, 19 studies; I2 = 66%) and 1.03% (0.45-1.80%, 14 studies; I2 = 89%), respectively. Sensitivity analyses did not find a statistically significant difference when adjusting for study size, diagnosis, or surgical approach.

CONCLUSIONS: Approximately 1.56% of sporadic PHPT patients eventually develop recurrence following parathyroidectomy. The initial diagnosis and procedure type does not influence recurrence rates. Consistent long-term follow-up is warranted to help identify recurrent disease.

PMID:37279502 | DOI:10.1210/clinem/dgad316

Health Promot Int. 2023 Jun 1;38(3):daad048. doi: 10.1093/heapro/daad048.

ABSTRACT

Non-pharmaceutical interventions (NPIs) implemented to mitigate the COVID-19 pandemic halted everyday life in higher education along with social and psychological impacts. The objective of our study was to explore the factors related to sense of coherence (SoC) from a gender perspective among university students in Turkey. This is a cross-sectional survey conducted online with a convenience sampling method as part of the international COVID-Health Literacy (COVID-HL) Consortium. SoC was measured by a nine-item questionnaire that was adapted to the Turkish language, including socio-demographic information and health status, including psychological well-being, psychosomatic complaints, and future anxiety (FA). 1595 students from four universities, of whom 72% were female, participated in the study. Cronbach’s alpha for the SoC scale was 0.75. Based on the median split of the individual scores, levels of SoC showed no statistically significant difference according to gender. Logistic regression analysis indicated that higher SoC was associated with medium and high subjective social status, studying in private universities, high psychological well-being, low FA, and none/one psychosomatic complaint. While results were similar among female students, type of university and psychological well-being showed no statistically significant association with SoC among males. Our results indicate that structural (subjective social status) and contextual (type of university) factors, along with gender-based variations, are associated with SoC among university students in Turkey.

PMID:37279469 | DOI:10.1093/heapro/daad048

Brief Bioinform. 2023 Jun 2:bbad208. doi: 10.1093/bib/bbad208. Online ahead of print.

ABSTRACT

Major histocompatibility complex (MHC)-peptide binding is a critical step in enabling a peptide to serve as an antigen for T-cell recognition. Accurate prediction of this binding can facilitate various applications in immunotherapy. While many existing methods offer good predictive power for the binding affinity of a peptide to a specific MHC, few models attempt to infer the binding threshold that distinguishes binding sequences. These models often rely on experience-based ad hoc criteria, such as 500 or 1000nM. However, different MHCs may have different binding thresholds. As such, there is a need for an automatic, data-driven method to determine an accurate binding threshold. In this study, we proposed a Bayesian model that jointly infers core locations (binding sites), the binding affinity and the binding threshold. Our model provided the posterior distribution of the binding threshold, enabling accurate determination of an appropriate threshold for each MHC. To evaluate the performance of our method under different scenarios, we conducted simulation studies with varying dominant levels of motif distributions and proportions of random sequences. These simulation studies showed desirable estimation accuracy and robustness of our model. Additionally, when applied to real data, our results outperformed commonly used thresholds.

PMID:37279464 | DOI:10.1093/bib/bbad208

Games Health J. 2023 Jun 6. doi: 10.1089/g4h.2022.0245. Online ahead of print.

ABSTRACT

Objective: To present the design, development, and pilot testing of Connections, an empirically derived cooperative card game intervention to reduce loneliness and enhance connection. Materials and Methods: Theory and empirical evidence from domains such as self-disclosure, interpersonal closeness, and serious games informed the design of this game. Iterative design was used to develop the intervention, followed by feasibility and preliminary efficacy pilot testing. Results: Pilot testing showed that participants felt confident playing the game and found Connections to be enjoyable, interesting, and helpful in building connections with others, and would recommend the game to others. Preliminary evaluation found statistically significant benefits across multiple domains after playing the game. Participants reported decreases in loneliness, depressed mood, and anxiousness (ps < 0.02). Additionally, participants reported increases in looking forward to forming new connections with others in the future, the degree to which they felt like opening up and talking to others, and the amount they felt like they had in common with others (ps < 0.05). Conclusion: Pilot testing of Connections demonstrated feasibility and preliminary impact among a community sample. Future development plans include minor revisions to the game instructions followed by more rigorous testing of the feasibility, usability, and efficacy of Connections among various settings and populations, with large samples and controlled trials.

PMID:37279459 | DOI:10.1089/g4h.2022.0245

J Infect Dev Ctries. 2023 May 31;17(5):684-692. doi: 10.3855/jidc.17141.

ABSTRACT

INTRODUCTION: Hand washing and the use of gloves in accordance with the standards are among the most significant methods used in infection control.

METHODOLOGY: This study is an analytical cross-sectional study. The sample of the study consisted of 132 health personnel working in the emergency department of a public hospital.

RESULTS: The mean of the hand hygiene belief scale was 85.50 ± 8.71, mean of the hand hygiene practice inventory was 67.70 ± 5.19. The participants’ mean general attitude towards the use of gloves was 43.71 ± 7.57, the mean of awareness about the use of gloves was 15.17 ± 3.88, the mean attitude towards the usefulness of glove use was 19.43 ± 1.47, and their attitude towards the necessity of using gloves was 12.63 ± 3.57. It was determined that glove usefulness score has a statistically significant and increasing effect on hand hygiene belief, while glove usefulness and glove awareness scores have statistically significant and increasing effects on hand hygiene practice.

CONCLUSIONS: This study determined that the hand hygiene beliefs and practices of the health personnel working in the emergency department are quite high, their attitudes towards the use of gloves are positive, the attitude towards the usefulness of glove use has a significant and increasing effect on hand hygiene belief, and glove usefulness and glove awareness attitudes have a significant and increasing effect on hand hygiene practice.

PMID:37279430 | DOI:10.3855/jidc.17141

J Infect Dev Ctries. 2023 May 31;17(5):677-683. doi: 10.3855/jidc.15873.

ABSTRACT

INTRODUCTION: The aim of this study was to analyze the adherence to standard precautions by nursing professionals in a public university hospital, and to identify associated factors.

METHODOLOGY: This was a cross-sectional study with the nursing staff of a public university hospital. The participants provided sociodemographic and immunization data, training data on standard precautions and occupational accident history, and responded to the questionnaire on adherence to standard precautions (QASP). Descriptive data analysis and Pearson’s Chi-square test (χ²) were performed, followed by Fisher’s exact test to verify the association between the adherence to standard precautions (total score ≥ 76 points) and the sample characterization variables. Additionally, binary logistic regression indicated the odds ratio (OR) of the sample characterization variables for adherence to standard precautions. A p value ≤ 0.05 was considered statistically significant.

RESULTS: The average score for adherence to standard precautions, through QASP, by nursing professionals evaluated was 70.5 points. Association between the adherence to standard precautions and the professionals’ sample characterization variables was not identified. However, it was observed that experienced professionals (≥15 years of experience in the institution) were more likely to adhere to standard precautions (OR 0.062; IC95% [0.006-0.663]; p = 0.021).

CONCLUSIONS: In general, the adherence to standard precautions by nursing professionals working in health service in this study can be considered inadequate, highlighting major weaknesses in hand hygiene practices, use of personal protective equipment (PPE), recapping of used needles, and conduct after suffering occupational accidents. Experienced professionals were more likely to adhere to standard precautions.

PMID:37279428 | DOI:10.3855/jidc.15873

J Infect Dev Ctries. 2023 May 31;17(5):617-622. doi: 10.3855/jidc.17268.

ABSTRACT

INTRODUCTION: As an endeavor to control SARS-CoV-2 infection, the Moderna vaccine booster was given to healthcare workers to prevent reinfection and reduce the risk of complications from COVID-19. A heterologous booster vaccine is also thought to provide better protection against the current SARS-CoV-2 variants of concern. However, research that evaluates the effectiveness of the Moderna vaccine booster and the resulting SARS-CoV-2 antibody concentration is needed.

OBJECTIVE: To evaluate the concentration of SARS-CoV-2 antibodies after the Moderna vaccine booster and the severity of SARS-CoV-2 infection before and after the Moderna vaccine booster.

RESULTS: A total of 93 healthcare providers who received Moderna vaccine booster were included in the study. Examination of antibody concentration 3 months after the booster showed an average concentration of 10081.65 U/mL. There was an increase in antibody concentration before the booster and 3 months after, from a median of 1.7 U/mL to 9540 U/mL. Every subject showed a statistically significant increment of antibody concentration 3 months after the booster (p < 0.01). Thirty-seven (39.8%) subjects received two doses of the Sinovac vaccine and were confirmed to have COVID-19 with the Delta variant. After the booster, 26 (28%) subjects were infected with the Omicron Variant. Among the subjects who received two doses of the Sinovac vaccine and were confirmed with COVID-19, 36 (30.1%) had mild symptoms, and 1 (1.1%) was asymptomatic.

CONCLUSIONS: Heterologous Moderna vaccine booster effectively increases antibody response against SARS-CoV-2 variants and shows mild symptoms of COVID-19 infection.

PMID:37279427 | DOI:10.3855/jidc.17268

J Infect Dev Ctries. 2023 May 31;17(5):610-616. doi: 10.3855/jidc.17508.

ABSTRACT

INTRODUCTION: The coronavirus disease 2019 (COVID-19) pandemic continues to have a global impact. The behavior and viral course of severe acute respiratory syndrome coronavirus (SARS-CoV-2) remains unpredictable. We aimed to investigate the prediction factors associated with prolonged viral shedding in COVID-19 patients.

METHODOLOGY: This is a retrospective, nested, case-control study with 155 confirmed COVID-19 infected patients divided into two groups based on nucleic acid conversion time (NCT), a prolonged group (viral RNA shedding >14 days, n = 31) and a non-prolonged group (n = 124).

RESULTS: The mean age of participants was 57.16 years, and 54.8% were male. Inpatient numbers were 67.7% across both groups. No statistically significant differences between the two groups were observed in terms of clinical manifestation, comorbidities, computer tomography, severity index, antiviral treatment, and vaccination. However, C-reactive protein and D-dimer levels were significantly higher in the prolonged group (p = 0.01; p = 0.01). Using conditional logistic regression analysis, D-dimer and bacterial co-infection were found to be independent factors associated with the prolonged NCT (OR: 1.001, 95% CI: 1.000-1.001, p = 0.043; OR: 12.479, 95% CI: 2.701-57.654, p = 0.001 respectively). We evaluated the diagnostic value of the conditional logistic regression model by using receiver operating characteristic curve analysis. The area under the curve was 0.7 (95% Cl: 0.574-0.802; p < 0.001).

CONCLUSIONS: Our study design included controlling confounders. We showed a clear result associating predicting factors with prolonged NCT of SARS-CoV-2. D-dimer level and bacterial co-infection were considered as independent predictors of prolonged NCT.

PMID:37279425 | DOI:10.3855/jidc.17508

J Infect Dev Ctries. 2023 May 31;17(5):597-609. doi: 10.3855/jidc.17791.

ABSTRACT

INTRODUCTION: Antimicrobial resistance (AMR) is a natural evolutionary process in bacteria that is accelerated by selection pressure from the frequent and irrational use of antimicrobial drugs. This study aimed to determine the variations in AMR patterns of priority bacterial pathogens at a tertiary care hospital in the Gaza Strip during pre- and post-COVID-19 pandemic.

METHODOLOGY: This is a retrospective observational study to determine the AMR patterns of bacterial pathogens at a tertiary hospital in the Gaza Strip in the post-COVID-19 pandemic period compared to the pre-COVID-19 period. Positive-bacterial culture data of 2039 samples from pre-COVID-19 period and 1827 samples from post-COVID-19 period were obtained from microbiology laboratory records. These data were analysed and compared by Chi square test using Statistical Package for Social Sciences (SPSS) Program.

RESULTS: Gram-positive and Gram-negative bacterial pathogens were isolated. Escherichia coli was the most prevalent in both study periods. The overall AMR rate was high. There was a statistically significant increase in resistance to cloxacillin, erythromycin, cephalexin, co-trimoxazole and amoxicillin/clavulanic acid in the post-COVID-19 period compared to pre-COVID-19 period. There was also a significant decrease in resistance to cefuroxime, cefotaxime, gentamicin, doxycycline, rifampicin, vancomycin and meropenem in the post-COVID-19 period.

CONCLUSIONS: During the COVID-19 pandemic, the AMR rates of restricted and noncommunity-used antimicrobials declined. However, there was an increase in AMR to antimicrobials used without medical prescription. Therefore, restriction on the sale of antimicrobial drugs by community pharmacies without a prescription, hospital antimicrobial stewardship and awareness about the dangers of extensive use of antibiotics are recommended.

PMID:37279421 | DOI:10.3855/jidc.17791